[…] Here’s a taste of how medical professionals are looking at the age wave, courtesy of Ardis Dee Hoven, MD, on an American Medical Association site in 2010:

The statistics are staggering. By age 65, around two-thirds of all seniors have at least one chronic disease and see seven physicians. Twenty percent of those older than 65 have five or more chronic diseases, see 14 physicians — and average 40 doctor visits a year. Situations like these are a nightmare for patients and the physicians who treat them.

Is any community ready for that?

What got me to thinking about this lately were two things. One was a timely diagnosis of the problem, especially as it applies to place, by Linda Selin Davis on The Atlantic Cities October 3 blog. Pointing to “the tainted legacy of age-segregated housing that is a $51 billion industry,” she nailed the unintended consequence of the “retirement community” movement:

We suffer from a severe lack of foresight, a shortage of personal and community planning when it comes to where and how to age. We’ve separated our elders from their extended families without replacing what their relatives might once have provided: a decent quality of life, until the very end.

The other insight feels like a solution, at least in a very targeted way. It comes from organizers of a senior cohousing initiative in Abingdon, VA called ElderSpirit Community. I’ve stayed in touch with them over the last decade because they provide one of my go-to antidotes for cynicism. Starting with few resources and little experience in neighborhood design, finance and development, they’ve assembled and successfully managed the intricate components of intentional community. And they’ve done that while measuring success against wildly idealistic standards. ElderSpirit members committed to a community designed for both physical and financial accessibility, for exploring spiritual purpose in broadly ecumenical ways and for supporting one another’s mental and physical well-being in the final stages of their lives.

[…]

Counting on volunteers to respond to those kinds of needs on a random basis doesn’t work. Some folks aren’t inclined to ask for help, so they don’t get it when they need it most. Meanwhile, dedicated volunteers over-commit and burn out quickly. The ElderSpirit answer – and the beginning of a new model for mutual support in community – is a system that matches people, skills and needs.

The community’s Care Committee established sort of a jobs bank of volunteers willing to take responsibility for tasks they felt best equipped to handle – transportation, say, or meals prep. Then they created a sort of buddy system, member-designated care coordinators to tap into the community support network. Each member was asked to pick two care coordinators, people they were comfortable confiding in and trusted to represent them. So when a need arises, the care coordinator activates the network.

[…]

Remember what Linda Selin Davis wrote in her blog post about “a shortage of personal and community planning.” That’s an understatement. Most Boomers will age in neighborhoods that are unlikely to sustain the kind of care network system ElderSpirit developed. They presume connectivity by car and exile anyone without the ability or desire to drive. The isolation that complicates every challenge in old age is designed into the places most Americans call home.

Arthur C. Nelson, director of the University of Utah’s Metropolitan Research Center, has been hammering away on this point for some time. Between 1950 and 2000, says Nelson, the share of Americans living in suburban areas rose from 27 percent to 52 percent; the suburban population grew by 100 million, from 41 million to 141 million; and suburbia accounted for three quarters of the nation’s population change.

The big push among advocates for seniors has been to build new homes and customize old ones for successful “aging in place.” Almost all of the emphasis has been on universal design, on assuring accessibility in individual homes through design and remodeling choices that make it easier to get around in wheel chairs, reach stuff in cabinets and on countertops and assure safety in bathrooms. But aging in places that isolate seniors in their homes, regardless of how easy it is to climb out of the bath tub, is not going to get at the bigger problem. Especially in an era in which the very demographic forces that have served us Boomers so well turn on us when we need help most. Says Nelson:

The American dream of owning one’s own home may result in millions of senior households living in auto-dependent suburban homes which have lost value compared to smaller homes in more central locations where many of their services will be located.

We all should be for strategies that allow for successful aging in place. But for the strategies to offer meaningful advantages to both seniors and their communities, they have to begin with making the right places.

The built environment is now the largest negative factor in the stability of ecosystems and the climate. As populations become increasingly urbanized, the evolution of cities will largely shape the outcome of our long dependence on natural resources. Two pathways of evolution are evident: an urban society that is in balance with the environment, or one that has depleted available natural capital. The decisions that will direct this evolution are being made now. It is clear that no single organization, profession or nation can achieve the goals of sustainable global development. It will require an architecture of solutions including low/no carbon buildings; sustainable economic systems; enhanced mobility; sustainable planning and energy policies; resilient social systems (access, equity and capacity), among countless others.

Recognizing the need and opportunity to improve sustainable building practices, Sitra, the Finnish Innovation Fund, in collaboration with the City of Helsinki, launched a sustainable development design competition. The goal was to attract and identify the best team to design a large building complex on a reclaimed harbour (Jätkäsaari) at the western edge of Helsinki’s central business district. The competition sought approaches for four central objectives applied at the scale of a city block:

1. low- and one day no- carbon emissions 2. energy efficiency 3. high architectural, spatial and social value 4. sustainable materials and methods

With the selection of a team comprised of Arup, Sauerbruch Hutton, Experientia and Galley Eco Capital, the competition is moving from ideas to implementation. This next phase includes not only design development of the architectural and strategic solution, but also many activities targeted at raising the level of awareness and sophistication of Finland’s national sustainability discussion. Work on the development has begun, with completion scheduled for the end of 2012.